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SORKIN'S RX LTD
DSH330307 CAYUGA MEDICAL CENTER AT ITHACA
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Covered Entity Details
Entity Name
CAYUGA MEDICAL CENTER AT ITHACA
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330307
Entity Address
101 DATES DRIVE
ITHACA, NY 14850
Medicare Provider Number
330307
Participating Start Date
7/1/2019
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
SORKIN'S RX LTD
Pharmacy Address
D/B/A CAREMED PHARMACEUTICAL SERVICES
1985 MARCUS AVE STE 130
NEW HYDE PARK, NY 11042-2024
Pharmacy Comments
Contract Details
Approval Date
5/22/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John Collett, CHIEF FINANCIAL OFFICER
(607) 274-4441
Contract Pharmacy Representative
SORKIN'S RX LTD
Bincy Varghese, Director of Pharmacy
(877) 227-3405 Ext: 9013
Signed By Date
5/22/2019
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